| 1. |
- Eksell, Jörgen, et al.
(författare)
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Tourists' place-making performances through music
- 2020
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Ingår i: The Routledge Companion to Media and Tourism. ; , s. 235-245
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Bokkapitel (refereegranskat)abstract
- Traditionally tourists are treated as passive media consumers but this chapter departs from a performance perspective emphasizing tourists’ active role. This chapter deals with how popular music affects tourists’ experiences in destinations by exploring the performance of place-making practices by tourists as they engage with music. The performance perspective is complemented with a ritual perspective that also allows an analysis of mundane practices. The problematization focus on two situations in Liverpool and highlight a number of different practices. The dynamics between planned and unplanned, and scripted and spontaneous performances are explored as well as the mediatized nature of these practices.
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| 2. |
- Ansari, Daniel, et al.
(författare)
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Surveillance after surgery for pancreatic cancer : a global scoping review of guidelines and a nordic survey of contemporary practice
- 2024
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708.
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries.Materials and Methods: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients.Results: Altogether 16 clinical practice guidelines and 17 research studies were included. The guidelines provided inconsistent recommendations regarding postoperative surveillance of pancreatic cancer. The clinical research data were mainly based on retrospective cohort studies with low level of evidence and lead-time bias was not addressed. Active surveillance was recommended in Sweden and Denmark, but not in Norway beyond the post-operative/adjuvant period. Finland had no national recommendations for surveillance. The Nordic survey revealed a wide variation in reported practice among the different units. About 75% (15 of 20 units) performed routine postoperative surveillance. Routine CA 19-9 testing was used by 80% and routine CT by 67% as part of surveillance. About 73% of centers continued follow-up until 5 years postoperatively.Conclusion: Evidence for routine long-term (i.e. 5 years) surveillance after pancreatic cancer surgery remains limited. Most pancreatic units in the Nordic countries conduct regular follow-up, but protocols vary.
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| 3. |
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| 4. |
- Bräutigam-Ewe, Marie, et al.
(författare)
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Two-year weight, risk and health factor outcomes of a weight-reduction intervention programme : Primary prevention for overweight in a multicentre primary healthcare setting
- 2020
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Ingår i: Scandinavian Journal of Primary Health Care. - Abingdon : Taylor & Francis Group. - 0281-3432 .- 1502-7724. ; 38:2, s. 192-200
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the long-term effects of weight reduction, quality of life and sense of coherence in a primary health care (PHC)-based programme with two different intensities. Design: Prospective two-armed randomised intervention. Setting: Three PHC centres in south west of Sweden. Subjects: In total, 289 women and men aged 40-65 years with a BMI of 28-35 were recruited for a two-year weight-reduction programme. Participants were randomized to high-intensity or low-intensity groups. Blood samples, physical measurements and questionnaires were analysed. Participants received cookbooks and dietary lectures. The high-intensity group also received Motivational interviewing (MI), dietary advice on prescription (DAP- advice), a grocery store lecture, a website and weekly e-mails. Main outcome measures: Weight, quality of life, risks and health factors. Results: In total, 182 (64%) participants completed the 2-year follow-up. The total sample reduced their weight by 1 kg (p = 0.006). No significant differences regarding weight were found between the groups. Anxiety/depression decreased in EQ5-D (p = 0.021), EQ5-D VAS (p = 0.002) and SOC (p = 0.042). Between the groups, there were significant differences in EQ5-D usual activities (p = 0.004), anxiety/depression (p = 0.013), pain/discomfort (p = 0.041), fruit and vegetables (p = 0.005), HLV anxiety (p = 0.005), and visits to nurses (p = 0.012). Conclusion: The total population lost weight, and the high-intensity and low-intensity programmes did not result in significant differences in terms of weight. The high-intensity programme reported health benefits linked to lower levels of anxiety and depression, increased activity and intake of greens and reduced visits to physicians and nurses.Key points Both groups had a consisting weight- reduction after two years. High intensity did not lead to a significant difference in weight reduction between the groups. The high-intensity group reported more health effects, such as better quality of life, reduced anxiety, and increased greenery intake. It is unknown how much support patients in a weight- reduction programme in PHC require to succeed with weight loss and a healthy lifestyle. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 5. |
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| 6. |
- Costache, Madalina Elena, et al.
(författare)
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Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder
- 2020
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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| 7. |
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| 8. |
- Eksell, Jörgen, et al.
(författare)
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Framtidens möten
- 2024
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Rapport (populärvet., debatt m.m.)abstract
- The Future of Meetings is about new business models, interaction, and communication in the meetings industry. The report examines how the pandemic has affected it and whether the crisis has brought new opportunities.It focuses on changes in the industry's value proposition, how guests in physical, hybrid and digital meetings and conferences interact and the role of hosting and hospitality in these. A good meeting is of great importance for the development of society.in addition, the report contains interviews with Annika Hallman, Head of Meetings, Göteborg & Co and Göteborg Convention Bureau, and Krister Andersson, CEO Umeå Congress.
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| 9. |
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| 10. |
- Eksell, Jörgen, et al.
(författare)
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Place-making of resilience in urban regions in the aftermath of Covid-19
- 2021
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Konferensbidrag (refereegranskat)abstract
- The Covid-19 pandemic has fundamentally changed travel patterns to and in major urban regions. Destinations have seen a dramatic shift from overtourism to undertourism. This has led to new challenges for regional destination management organisations (DMOs) as tourists and residents seek green areas in cities and visit adjacent natural reserves. Therefore this research explores how the Covid-19 pandemic has reconceptualised the relationship between the urban and rural in densely populated regions. In particular the paper discusses the relationship between media narratives, tourism flows, and place-making, and the implications for resilience in urban regions.This paper departs from theories of geography of communication (GoC). Media and communication scholars have this far been largely absent from resilience theorising and research (Houston et al., 2015). GoC explores the interconnectedness of media and space and has evolved as a result of the spatial turn (see Warf & Arias, 2009; Adams & Jansson, 2012). In addition, this paper introduces place-making of tourists, i.e. the organic and unplanned behaviour and actions of individuals (Lew, 2017) to further emphasize the consequences for resilience in regions. Place-making is generally separated from placemaking which imply a top-down plan and design of places reflecting norms and political structures of the community (Lew, 2017).The data consists of interviews with relevant stakeholders (DMO representatives and managers of nature reserves and tourist attractions) and online news media texts on the region Scania, Sweden. The region offers cities such as Malmoe and Lund, small towns and rural landscapes with a large number of national parks and reserves. A paradigmatic analysis of narratives that locate common themes or conceptual manifestations was conducted on the collected data (cf. Polkinghorne 1995). The reason is that narratives turn information and events into something that seems to be naturally occurring and meaningful to those encountering the narratives. The analysis reveals an intimate relationship between resilience in places and media narratives, and how the latter transform both conceptions of urban and rural places and place-making. During the pandemic, green and rural areas as well as natural reserves are contrived as places of physical distance. The latter is commonly understood as safe places and in consequence, new tourist groups have travelled to these areas. Tourists have performed place-making such as hiking and cycling on trails, but also set up fires in undesignated areas, and littered in reserves. To cope with the surge of tourists, site management of reserves has introduced new placemaking regimes such as parking services etc. The pandemic has changed the place-making of tourists, which in turn has affected the resilience of the places. The study points to a need for regional DMOs to not only develop placemaking in these areas, but also develop a GoC approach to place-making of tourists. The GoC-perspective advances an interdisciplinary approach to resilience in places that reveals how both place-making and the constitution of resilience in tourism places are molded by the politics by media and communication practices of a number of stakeholders.ReferencesAdams, P. C. & Jansson, A. (2012) Communication Geography: A Bridge Between Disciplines. Communication Theory, 22(3), 299–318.Berbés-Blázquez, M. & Scott, D. (2017) The Development of Resilience Thinking. In Butler, R. W. (Ed.), Tourism and resilience: 9-22. Allingford, Oxfordshire: CABI. Butler, R. (Ed) (2017) Tourism and resilience. Allingford: CABI. Houston, J. B., Spialek, m. L., Cox, J., Greenwood, M. M., & First, J. (2015). The Centrality of Communication and Media in Fostering Community Resilience: A Framework for Assessment and Intervention, American Behavioural Scientist, 59 (2): 270-283Lew A. A. (2017). Tourism planning and place making: place-making or placemaking? Tourism Geographies. 2017;19(3):448-466. Warf, B. & Arias, S. (2009). The Reinsertion of space in social sciences and humanities. In B.Warf, & S. Arias (Eds). The spatial turn: interdisciplinary perspectives: 1-10. London: Routledge.
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| 11. |
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| 12. |
- Eksell, Jörgen, et al.
(författare)
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Semester på hemmaplan? Personer med utländsk bakgrunds resvanor och turismkonsumtion i Sverige.
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Sweden is a multicultural country in which about 20 percent of the population has a foreign background. People who belong to different population groups live here and have diverse cultural backgrounds and lifestyles. This means that the Swedish tourism and hospitality industry today communicates with a very diversified Swedish target group.This report, which is the result of a commissioned research project for Visit Sweden, is thus aimed at you who want to understand this growing target group. The study sheds light on Swedes with a foreign background in tourism consumption in Sweden by examining the segment's knowledge of Swedish destinations, sources for travel inspiration, travel reasons and obstacles to vacationing more in Sweden. The study shows that the foreign background is less important for tourism consumption compared with socioeconomics, level of education and establishment in the labor market. However, the segment is very heterogeneous and that there are few reasons to treat people with this background as a segment. Therefore, the report offers nuances about the segment people with foreign background, rather than general conclusions. The report also contributes with increased knowledge of how the Swedish tourism and hospitality industry can form offers to this target group. Inclusive communication is presented at one of several paths to improve communication, with swedes with foreign background.
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| 13. |
- Eksell, Jörgen, et al.
(författare)
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The communication for resilience of urban destinations during the COVID-19 pandemic.
- 2022
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Konferensbidrag (refereegranskat)abstract
- This paper explores how urban Destination Management Organisations (DMOs) in Sweden, have understood their communicative role, developed communicative strategies and tactics during the COVID-19 pandemic. The overall aim of this research is to develop understanding of the role of communication strategies for developing urban destination resilience. This study is conducted in collaboration with the Swedish network of destination management organisations (SNDMO) in a research project financed by the Swedish Agency for Economic and Regional Growth (2021-2022). 40 semi-structured interviews with members of SNDMO were performed. The results show that in order to deal with the difficult situation many new stakeholder collaborations have started. An obstacle is the complexity that comes with stakeholder communication that includes several actors. The communicative role of the DMOS has expanded during the pandemic. The communicative strategies and tactics that evolved during the crisis are characterised by handling a number of contradictions and dilemmas. The results indicate the success of the DMO is dependent on its ability to be proactive, adapt to a constantly changing environment, and use established networks for communication work. This project increases the understanding of communicative strategies employed for urban resilience that emerges in complex interactions between stakeholders and the communicative role of DMOs in extraordinary situations.
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| 14. |
- Holtedahl, K., et al.
(författare)
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Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care
- 2021
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Ingår i: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In an abdominal symptom study in primary care in six European countries, 511 cases of cancer were recorded prospectively among 61,802 patients 16years and older in Norway, Denmark, Sweden, Netherlands, Belgium and Scotland. Colorectal cancer is one of the main types of cancer associated with abdominal symptoms; hence, an in-depth subgroup analysis of the 94 colorectal cancers was carried out in order to study variation in symptom presentation among cancers in different anatomical locations. Method: Initial data capture was by completion of standardised forms containing closed questions about symptoms recorded during the consultation. Follow-up data were provided by the GP after diagnosis, based on medical record data made after the consultation. GPs also provided free text comments about the diagnostic procedure for individual patients. Fisher’s exact test was used to analyse differences between groups. Results: Almost all symptoms recorded could indicate colorectal cancer. ‘Rectal bleeding’ had a specificity of 99.4% and a PPV of 4.0%. Faecal occult blood in stool (FOBT) or anaemia may indicate gastrointestinal bleeding: when these symptoms and signs were combined, sensitivity reached 57.5%, with 69.2% for cancer in the distal colon. For proximal colon cancers, none of 18 patients had ‘Rectal bleeding’ at the initial consultation, but three of the 18 did so at a later consultation. ‘Abdominal pain, lower part’, ‘Constipation’ and ‘Distended abdomen, bloating’ were less specific and also less sensitive than ‘Rectal bleeding’, and with PPV between 0.7% and 1.9%. Conclusions: Apart from rectal bleeding, single symptoms did not reach the PPV 3% NICE threshold. However, supplementary information such as a positive FOBT or persistent symptoms may revise the PPV upwards. If a colorectal cancer is suspected by the GP despite few symptoms, the total clinical picture may still reach the NICE PPV threshold of 3% and justify a specific referral. © 2021, The Author(s).
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| 15. |
- Holtedahl, Knut, et al.
(författare)
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Symptoms and signs of urogenital cancer in primary care
- 2023
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Ingår i: BMC primary care. - : BMC. - 2731-4553. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Urogenital cancers are common, accounting for approximately 20% of cancer incidence globally. Cancers belonging to the same organ system often present with similar symptoms, making initial management challenging. In this study, 511 cases of cancer were recorded after the date of consultation among 61,802 randomly selected patients presenting in primary care in six European countries: a subgroup analysis of urogenital cancers was carried out in order to study variation in symptom presentation. METHODS: Initial data capture was by completion of standardised forms containing closed questions about symptoms recorded during the consultation. The general practitioner (GP) provided follow-up data after diagnosis, based on medical record data made after the consultation. GPs also provided free text comments about the diagnostic procedure for individual patients. RESULTS: The most common symptoms were mainly associated with one or two specific types of cancer: 'Macroscopic haematuria' with bladder or renal cancer (combined sensitivity 28.3%), 'Increased urinary frequency' with bladder (sensitivity 13.3%) or prostatic (sensitivity 32.1%) cancer, or to uterine body (sensitivity 14.3%) cancer, 'Unexpected genital bleeding' with uterine cancer (cervix, sensitivity 20.0%, uterine body, sensitivity 71.4%). 'Distended abdomen, bloating' had sensitivity 62.5% (based on eight cases of ovarian cancer). In ovarian cancer, increased abdominal circumference and a palpable tumour also were important diagnostic elements. Specificity for 'Macroscopic haematuria' was 99.8% (99.7-99.8). PPV>3% was noted for 'Macroscopic haematuria' and bladder or renal cancer combined, for bladder cancer in male patients. In males aged 55-74, PPV=7.1% for 'Macroscopic haematuria' and bladder cancer. Abdominal pain was an infrequent symptom in urogenital cancers. CONCLUSIONS: Most types of urogenital cancer present with rather specific symptoms. If the GP considers ovarian cancer, increased abdominal circumference should be actively determined. Several cases were clarified through the GP's clinical examination, or laboratory investigations.
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| 16. |
- Månsson, Maria, et al.
(författare)
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A communicative approach to resilience in urban regions
- 2021
-
Konferensbidrag (refereegranskat)abstract
- The Covid-19 pandemic has fundamentally changed travel patterns to and in urban regions. Destinations have seen a dramatic shift from overtourism to undertourism. This research explores how the pandemic has reconceptualised the relationship between the urban and rural. In particular this paper discusses the relationship between media narratives and tourism flows, and the implications for resilience in urban regions.This paper departs from theories of geography of communication (GoC). Media and communication scholars have this far been largely absent from resilience theorising and research (Houston et al., 2015). GoC explores the interconnectedness of media and space and has evolved as a result of the spatial turn (see Warf & Arias, 2009; Adams & Jansson, 2012). The data consists of interviews with relevant stakeholders (DMO representatives and managers of nature reserves and tourist attractions) and online news media texts on the region Scania, Sweden. The region offers cities such as Malmoe and Lund, small towns and rural landscapes with national parks and reserves. A paradigmatic analysis of narratives that locate common themes or conceptual manifestations was conducted on the collected data (cf. Polkinghorne 1995). The reason is that narratives turn information and events into something that seems to be naturally occurring and meaningful to those encountering the narratives. The analysis shows the intimate relation between resilience in places and media narratives, and how the latter transform both conceptions and practices about resilience in places. Rural areas as well as natural reserves are contrived as places of physical distance and therefore attractive for urban dwellers and visitors. These places are constructed as sustainable and safe places even with large numbers of visitors. Accordingly, the GoC-perspective advances an interdisciplinary approach to resilience in tourist places that reveals how the constitution of resilience in urban destinations is moulded by the politics of media and communication practices.ReferencesAdams, P. C. & Jansson, A. (2012) Communication Geography: A Bridge Between Disciplines. Communication Theory, 22(3), 299–318.Houston, J. B., Spialek, m. L., Cox, J., Greenwood, M. M., & First, J. (2015). The Centrality of Communication and Media in Fostering Community Resilience: A Framework for Assessment and Intervention, American Behavioural Scientist, 59(2), 270-283Lew AA. Tourism planning and place making: place-making or placemaking? Tourism Geographies. 2017;19(3):448-466.Polkinghorne, D. (1995) Narrative configuration in qualitative analysis. Qualitative studies in education, 8(1), 5- 23.Warf, B. & Arias, S. (2009). The Reinsertion of space in social sciences and humanities. In B.Warf, & S. Arias (Eds). The spatial turn: interdisciplinary perspectives: 1-10. London: Routledge.
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| 17. |
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| 18. |
- Månsson, Maria, et al.
(författare)
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A resilience approach to DMO communication during the COVID-19 pandemic.
- 2022
-
Konferensbidrag (refereegranskat)abstract
- This article addresses how urban Destination Management Organisations (DMOs) in Sweden, have understood their communicative role, developed communicative strategies and tactics in relation to stakeholders during the COVID-19 pandemic. The aim of this research is to explore communication strategies for urban destination resilience. DMOs have a key role in balancing the interest of stakeholders, the management and branding of a destination, and attracting visitors (Rodríguez-Díaz & Espino-Rodríguez, 2008; Stienmetz & Fesenmaier, 2019). DMOs are expected to facilitate the conditions for other organisations within a defined administrative boundary to meet political ambitions concerning economic and sustainable development (Elbe et al., 2017). Hence, urban DMOs have a particularly challenging communicative task given the number of stakeholders involved in a tourist destination. DMOs often have limited budgets (Pike, 2004), work in complex organizational settings, representing municipal, political, and industry interests, and work with stakeholders of various fields of operation, size, interest, and budget. Several previous studies have pointed to the arduous task of DMOs to develop a strategy to mobilize resources controlled by others (Buhalis, 2000; Gretzel et al., 2006). While the DMO is a central actor in the destination, the literature indicates that the task of the urban DMO is complex and challenging given the number of involved stakeholders and limited resources and decision-making power. Resilience at a destination is based on the individual and the organisational level and how these levels are connected to different networks in the tourism system like businesses, government, NGO’s and the community (Hall et al., 2017). The different stakeholder networks within each destination and surrounding regions are also of importance. Research concludes that the more range of networks there is, the more resilient is the destination (Hall et al., 2017). However, resilience is not the same for all stakeholders. It is important to take into consideration: resilience for whom, what, when, where, and why? (cf. Meerow et al, 2016). This needs to be carefully considered when developing the communicative strategies.This research is conducted in collaboration with the Swedish network of destination management organisations (SNDMO) in a research project financed by the Swedish Agency for Economic and Regional Growth (2021-2022). During 2021, 40 semi-structured interviews with members of SNDMO were performed. Additionally, a couple of DMOs in different urban regions in Sweden have been selected as partners to identify and discuss problems and best practises to develop communication strategies in collaboration. To deal with the difficult situation, DMOs established many new stakeholder collaborations locally. A hurdle in these collaborations is the complexity that comes with stakeholder communication that includes local businesses, residents, public organisations and so forth. Additionally, the communicative role of the DMOS has expanded during the pandemic and accentuated new actors and relationships. The communicative strategies and tactics that evolved during the crisis in relation to stakeholders are characterised by handling several contradictions and dilemmas. The results indicate the success of the DMO is dependent on its ability to be proactive, adapt to a constantly changing environment, and use established networks for communication work. To conclude, this ongoing project increases the understanding of communicative strategies employed for urban resilience that emerges in complex interactions between different stakeholders and the communicative role of DMOs in an extraordinary situation. References Buhalis, D. (2000) Marketing the competitive destination of the future, Tourism Management, 21, 97–116. Elbe, J., Gebert Persson, S., Sjöstrand, F. & Ågren, K. (2018), Network approach to public-private organizing of destinations, IMP Journal, 12(2), 313-332. https://doi.org/10.1108/IMP-06-2017-0035 Gretzel U., Fesenmaier DR, Formica S. & O’Leary JT. (2006) Searching for the Future: Challenges Faced by Destination Marketing Organizations. Journal of Travel Research, 45(2), 116-126. doi:10.1177/0047287506291598 Hall, C.M., Prayag, G. & Amore, A. (2017). Tourism and resilience: individual, organisational and destination perspectives. Channel View Publications. Meerow, S. & Newell, J. P. (2019) Urban resilience for whom, what, when, where, and why?, Urban Geography, 40:3, 309-329, DOI: 10.1080/02723638.2016.1206395 Pike, S. (2004). Destination Marketing Organisations. Elsevier Rodríguez-Díaz M. & Espino-Rodríguez TF. (2008). A Model of Strategic Evaluation of a Tourism Destination Based on Internal and Relational Capabilities. Journal of Travel Research, 6(4), 368-380. doi:10.1177/0047287507308324 Stienmetz JL & Fesenmaier DR. (2019). Destination Value Systems: Modeling Visitor Flow Structure and Economic Impact. Journal of Travel Research, 58(8), 1249-1261. doi:10.1177/0047287518815985
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| 19. |
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| 20. |
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| 21. |
- Oja, C., et al.
(författare)
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Awareness of parental illness: a grounded theory of upholding family equilibrium in parents on long-term sick-leave in primary health care
- 2021
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 39:3, s. 268-278
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Tidskriftsartikel (refereegranskat)abstract
- Objective To understand the main concern of chronically ill parents and how they resolve this concern in relation to their children. Design Grounded theory. Setting Three primary health care clinics in Sweden. Subjects Thirty-two interviewed parents and their children. Main outcome measures Processes and typologies of upholding family relationships. Results A concern of chronically ill parents is sustaining family equilibrium, achieved through a process of upholding family relationships. How a parent upholds depends upon his/her comprehension of the illness and of their child's need for parenting. In response to the parent's upholding behaviours, children mirror the effect of the illness to the parent, the child's specific behaviour depending on his/her level of comprehension regarding the parent's illness. Their combined behaviours create an awareness context that may be closed, concealed, suspicious, conflicted, mutual pretence or open. When the parent drives and facilitates the evolution of comprehension, the context quickly evolves from closed to open. When the parent hinders the process by masking and resisting the child responds by probing and proving and they become locked into a suspicious or conflicted awareness context with high relational tension. To create family equilibrium the parent needs to reveal and facilitate the awareness process. Conclusion Parents on long-term sick leave in primary health care can need assistance to facilitate the awareness context of themselves and their child. Implications: Clinicians can identify the current awareness context of their patient and help their patient towards increased understanding of their illness; their child's needs and the parental capacities needed to reveal the illness and its impacts.
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| 22. |
- Oja, C., et al.
(författare)
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Informing children of their parent's illness: A systematic review of intervention programs with child outcomes in all health care settings globally from inception to 2019
- 2020
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Children are impacted when parents are ill. This systematic review gives an overview of the current state of research and extracts what children and parents found helpful in the interventions aimed at informing children of their parent's illness. Methods This review was registered with PROSPERO and conducted in accordance with PRISMA guidelines. Five health and social science databases were searched from inception to November 2019 to identify original, peer-reviewed articles in English describing effective interventions. The authors selected and reviewed the studies independently, and any inconsistencies were resolved by discussion in face-to-face meetings and emails. A descriptive synthesis of evidence-based concepts from quantitative and qualitative studies was conducted. Results A total of 13 892 titles and 144 full-text articles were reviewed with 32 selected for final inclusion, 21 quantitative, 11 qualitative and no mixed-method studies published from 1993 to November 2019. Most of the research was conducted in mental health, including substance abuse (n = 22), but also in cancer care (n = 6) and HIV care (n = 4). Most studies using quantitative method showed a small to moderately positive statistically significant intervention effect on the child's level of internalized symptoms. Content analysis of the results of studies employing qualitative methodology resulted in four concepts important to both children and parents in interventions (increased knowledge, more open communication, new coping strategies and changed feelings) and three additional concepts important to parents (observed changes in their children's behavior, the parent's increased understanding of their own child and the relief of respite). Conclusions In the literature there is evidence of mild to moderate positive effects on the child's level of internalized symptoms as well as concepts important to children and parent's worth noting when trying to bridge the still existing knowledge gaps. In further efforts the challenges of implementation as well as adaptation to differing clinical and personal situations appear key to address.
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| 23. |
- Rendboe, Amalie Katrine, et al.
(författare)
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The Epidome : a species-specific approach to assess the population structure and heterogeneity of Staphylococcus epidermidis colonization and infection
- 2020
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Ingår i: BMC Microbiology. - : Springer Science and Business Media LLC. - 1471-2180. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAlthough generally known as a human commensal, Staphylococcus epidermidis is also an opportunistic pathogen that can cause nosocomial infections related to foreign body materials and immunocompromized patients. Infections are often caused by multidrug-resistant (MDR) lineages that are difficult and costly to treat, and can have a major adverse impact on patients’ quality of life. Heterogeneity is a common phenomenon in both carriage and infection, but present methodology for detection of this is laborious or expensive.In this study, we present a culture-independent method, labelled Epidome, based on an amplicon sequencing-approach to deliver information beyond species level on primary samples and to elucidate clonality, population structure and temporal stability or niche selection of S. epidermidis communities.ResultsBased on an assessment of > 800 genes from the S. epidermidis core genome, we identified genes with variable regions, which in combination facilitated the differentiation of phylogenetic clusters observed in silico, and allowed classification down to lineage level. A duplex PCR, combined with an amplicon sequencing protocol, and a downstream analysis pipeline were designed to provide subspecies information from primary samples. Additionally, a probe-based qPCR was designed to provide valuable absolute abundance quantification of S. epidermidis. The approach was validated on isolates representing skin commensals and on genomic mock communities with a sensitivity of < 10 copies/μL. The method was furthermore applied to a sample set of primary skin and nasal samples, revealing a high degree of heterogeneity in the S. epidermidis populations. Additionally, the qPCR showed a high degree of variation in absolute abundance of S. epidermidis.ConclusionsThe Epidome method is designed for use on primary samples to obtain important information on S. epidermidis abundance and diversity beyond species-level to answer questions regarding the emergence and dissemination of nosocomial lineages, investigating clonality of S. epidermidis communities, population dynamics, and niche selection. Our targeted-sequencing method allows rapid differentiation and identification of clinically important nosocomial lineages in low-biomass samples such as skin samples.
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| 24. |
- Wlad, Magdalena, et al.
(författare)
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Dorsal anterior cingulate cortex activity during cognitive challenge in social anxiety disorder
- 2023
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Ingår i: Behavioural Brain Research. - : Elsevier. - 0166-4328 .- 1872-7549. ; 442
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social anxiety disorder (SAD) is associated with aberrant emotional information processing while little is known about non-emotional cognitive processing biases. The dorsal anterior cingulate cortex (dACC) has been implicated in SAD neuropathology and is activated both by emotional and non-affective cognitive challenges like the Multisource Interference Task (MSIT).Methods: Here, we used fMRI to compare dACC activity and test performance during MSIT in 69 SAD patients and 38 healthy controls. In addition to patient-control comparisons, we examined whether neural activity in the dACC correlated with social anxiety, trait anxiety or depression levels.Results: The MSIT activated the dACC as expected but with no differences in task performance or neural reactivity between SAD patients and controls. There were no significant correlations between dACC activity and social or trait anxiety symptom severity. In patients, there was a significant negative correlation between dACC activity and depressive symptoms.Conclusions: In absence of affective challenge, we found no disorder-related cognitive profile in SAD patients since neither MSIT task performance nor dACC neural activity deviated in patients relative to controls.
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